# Al Gore’s Health Care Plan on NPR **URL:** \ **Category:** Great Debates\ **Created:** [November 21, 2002, 3:34pm UTC](https://boards.straightdope.com/t/al-gore-s-health-care-plan-on-npr/137950 "2002-11-21T15:34:47Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![Threadkiller](https://avatars.discourse-cdn.com/v4/letter/t/aca169/32.png) [@Threadkiller](https://boards.straightdope.com/u/Threadkiller)\ **Post date:** [November 21, 2002, 3:34pm UTC](https://boards.straightdope.com/t/al-gore-s-health-care-plan-on-npr/137950/1 "2002-11-21T15:34:47Z")
From today’s NPR morning edition, they had an interview session with Al Gore. It was rather softball (but this early in the campaign cycle as the closest thing to a serious democratic candidate he has earned it) and decidedly non-confrontational. One segment made me sit up: > [@](#): > > _From [NPR](http://www.npr.org/ramfiles/me/20021121.me.03.ram). The following is my best attempt at a transcription, I claim all mistakes as my own._ > > Al Gore: “I think that it [health care] ought to be private with coverage for individuals. And I think that it’s time to have a serious national debate about how to make a universal system work…” > > NPR: “Who would pay?” > > Al Gore: “We could pay less than we are paying now and still have not only the best insurance system in the world but stop cutting the coverage and raising the premiums.” > > [They then go on to the Middle East.] My question is: How? How can we pay less and get more? Obviously this will require massive overhaul of something or other. Gore gives a nice teaser but doesn’t bother lay out (or even outline) what he has in mind. I readily admit that health care in the US is in trouble. We do have a looming crisis with the un (and under) insured while costs for expenses and coverage continue to rise. What does Gore have in mind? ---
**Author:** ![december](https://avatars.discourse-cdn.com/v4/letter/d/838e76/32.png) [@december](https://boards.straightdope.com/u/december)\ **Post date:** [November 21, 2002, 4:16pm UTC](https://boards.straightdope.com/t/al-gore-s-health-care-plan-on-npr/137950/2 "2002-11-21T16:16:36Z")
> [@](#): > > \*Originally posted by Threadkiller \* > \*\*What does Gore have in mind? \*\* In another interview, Gore espoused a single-payer system. If the US government paid for all health care, they could set lower prices for doctors, hospitals, medicine, etc. So, the saving could come from reducing the payment make to health-care providers. Of course, there would be a risk that a reduction in payments would lead to a reduction in quality and quantity of care. This article provides a warning about the [risks of too much price control.](http://www.rollcall.com/pages/columns/kondracke/) > [@](#): > > Physicians are considering abandoning Medicare patients in droves because the federal government is about to cut their reimbursement rate again and Congress seems unwilling to do anything about it. > > It’s a warning of what could happen if the entire U.S. health system is government-dominated - and, ultimately, politicized. Of course, if the US controlled the _entire_ health-care market and if individual payments to physicians were prohibited, then the physicians would have no where else to go… ---
**Author:** ![erislover](https://avatars.discourse-cdn.com/v4/letter/e/71e660/32.png) [@erislover](https://boards.straightdope.com/u/erislover)\ **Post date:** [November 21, 2002, 4:21pm UTC](https://boards.straightdope.com/t/al-gore-s-health-care-plan-on-npr/137950/3 "2002-11-21T16:21:10Z")
Except to engineering. ---
**Author:** ![Liberal](https://avatars.discourse-cdn.com/v4/letter/l/848f3c/32.png) [@Liberal](https://boards.straightdope.com/u/Liberal)\ **Post date:** [November 21, 2002, 4:27pm UTC](https://boards.straightdope.com/t/al-gore-s-health-care-plan-on-npr/137950/4 "2002-11-21T16:27:14Z")
> [@](#): > > The truth is that the alternative is not between a dead mechanism or a rigid automatism on one hand and conscious planning on the other hand. The alternative is not plan or no plan. The question is whose planning? Should each member of society plan for himself, or should a benevolent government alone plan for them all? The issue is not automatism versus conscious action; it is autonomous action of each individual versus the exclusive action of the government. It is freedom versus government omnipotence. > > Laissez faire does not mean: Let soulless mechanical forces operate. It means: Let each individual choose how he wants to cooperate in the social division of labor; let the consumers determine what the entrepreneurs should produce. Planning means: Let the government alone choose and enforce its rulings by the apparatus of coercion and compulsion. > > Under laissez faire, says the planner, it is not those goods which people “really” need that are produced, but those goods from the sale of which the highest returns are expected. It is the objective of planning to direct production toward the satisfaction of the “true” needs. But who is to decide what the “true” needs are? Ludwig von Mises, _Human Action_, Chapter XXVII, “The Government and the Market”, Section 5, “The Meaning of Laissez Faire”, page 731. ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [November 21, 2002, 4:49pm UTC](https://boards.straightdope.com/t/al-gore-s-health-care-plan-on-npr/137950/5 "2002-11-21T16:49:25Z")
The American public wants the best health care in the world, available to everybody, and at a reasonable cost. They can get, at most, any two of these three. There is no combination of circumstances under which they can get more than that. The idea that the government can make something cost less by passing a law is what ended the USSR. ---
**Author:** ![ElJeffe](https://avatars.discourse-cdn.com/v4/letter/e/958977/32.png) [@ElJeffe](https://boards.straightdope.com/u/ElJeffe)\ **Post date:** [November 21, 2002, 4:56pm UTC](https://boards.straightdope.com/t/al-gore-s-health-care-plan-on-npr/137950/6 "2002-11-21T16:56:20Z")
If you want to see what Gore had in mind, I would say look to Canada, in all it’s medically-deficient, long-line-laden, patients-fleeing-the-border-to-be-treated-in-the-US glory. Hey, sign me up! Jeff ---
**Author:** ![UDS](https://avatars.discourse-cdn.com/v4/letter/u/ecae2f/32.png) [@UDS](https://boards.straightdope.com/u/UDS)\ **Post date:** [November 21, 2002, 5:20pm UTC](https://boards.straightdope.com/t/al-gore-s-health-care-plan-on-npr/137950/7 "2002-11-21T17:20:03Z")
Or, more productively, you could look at countries that pay less for health care than the US does and, by all conventional measures, enjoy better public health. Who knows, there might be _something_ useful to be learnt, even if it is only what they have to sacrifice to achieve this. Then there could be a rational debate about whether the sacrifice was worthwhile. ---
**Author:** ![ElJeffe](https://avatars.discourse-cdn.com/v4/letter/e/958977/32.png) [@ElJeffe](https://boards.straightdope.com/u/ElJeffe)\ **Post date:** [November 21, 2002, 6:12pm UTC](https://boards.straightdope.com/t/al-gore-s-health-care-plan-on-npr/137950/8 "2002-11-21T18:12:41Z")
> [@](#): > > Or, more productively, you could look at countries that pay less for health care than the US does and, by all conventional measures, enjoy better public health. This can provide some useful insight, but not as much as you may think. Without accounting for such factors as genetic makeup of the population, geography, population density, and other things, such data isn’t particularly useful. Even talking about the US as a whole is misleading, as the factors I mentioned vary wildly even from state to state. Jeff ---
**Author:** ![erislover](https://avatars.discourse-cdn.com/v4/letter/e/71e660/32.png) [@erislover](https://boards.straightdope.com/u/erislover)\ **Post date:** [November 21, 2002, 6:17pm UTC](https://boards.straightdope.com/t/al-gore-s-health-care-plan-on-npr/137950/9 "2002-11-21T18:17:14Z")
Sure, **UDS** , America-style capitalism works the same everywhere, so should universal health care, right? That follows, right? ---
**Author:** ![tourbot](https://avatars.discourse-cdn.com/v4/letter/t/e95f7d/32.png) [@tourbot](https://boards.straightdope.com/u/tourbot)\ **Post date:** [November 21, 2002, 6:34pm UTC](https://boards.straightdope.com/t/al-gore-s-health-care-plan-on-npr/137950/10 "2002-11-21T18:34:02Z")
> [@](#): > > \*Originally posted by Shodan \* > \*\*The American public wants the best health care in the world, available to everybody, and at a reasonable cost. > > They can get, at most, any two of these three. There is no combination of circumstances under which they can get more than that.\*\* But we currently have **none** of those three. Surely, then, there is room for progress on all three counts. Yes, the “best health care in the world” is debatable, and, to a large extent, purely subjective. But there are several measurable categories (infant mortality and life expectancy spring to mind, but there are others as well) in which the US trails other industrial nations by a large margin. And eris, I don’t think UDS was implying that some other countries healthcare system (as if they are all the same anyway) could be imposed without modification to the US, but that: > [@](#): > > there might be something useful to be learnt ---
**Author:** ![Spoke](https://avatars.discourse-cdn.com/v4/letter/s/a88e57/32.png) [@Spoke](https://boards.straightdope.com/u/Spoke)\ **Post date:** [November 21, 2002, 6:36pm UTC](https://boards.straightdope.com/t/al-gore-s-health-care-plan-on-npr/137950/11 "2002-11-21T18:36:46Z")
> [@](#): > > How can we pay less and get more? Under our current system, you pay a premium to your insurer, and your insurer pays your health care provider. That means we have two layers of people who profit from the money you pay for health care. Your insurer takes a profit, and the health care provider takes a profit. If the government were to step into the insurer’s role, one layer of profit-taking would be eliminated. (The government does not need to build a profit into the “premiums” it would charge.) Thus (in theory, at least) you could pay less and get the same or better health care result. Could this be done in an efficient way _in practice_ (and without eliminating or drastically reducing profit incentives for medical care providers)? That’s the real question. Don’t kid yourself, though. The insurance industry is making a killing, and they will fight tooth and nail to prevent the implementation of such a system. ---
**Author:** ![Threadkiller](https://avatars.discourse-cdn.com/v4/letter/t/aca169/32.png) [@Threadkiller](https://boards.straightdope.com/u/Threadkiller)\ **Post date:** [November 21, 2002, 7:38pm UTC](https://boards.straightdope.com/t/al-gore-s-health-care-plan-on-npr/137950/12 "2002-11-21T19:38:44Z")
> [@](#): > > \*Originally posted by spoke- \* > …If the government were to step into the insurer’s role… This differs from Gore’s plan. He specifically said private insurance. > [@](#): > > Could this be done in an efficient way _in practice_ (and without eliminating or drastically reducing profit incentives for medical care providers)? That’s the real question. Indeed. For me “government efficiency” is all too often an oxymoron. > [@](#): > > Don’t kid yourself, though. The insurance industry is making a killing, and they will fight tooth and nail to prevent the implementation of such a system. Would there be legal or constitutional issues with the government taking over a normally private institution? Would you also be for the government taking over in the malpractice insurance business? If I understand correctly, the high cost that medical practitioners have to pay for insurance is a driving factor in the rising cost of health care. ---
**Author:** ![Guinastasia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guinastasia/32/5751_2.png) [@Guinastasia](https://boards.straightdope.com/u/Guinastasia)\ **Post date:** [November 21, 2002, 7:49pm UTC](https://boards.straightdope.com/t/al-gore-s-health-care-plan-on-npr/137950/13 "2002-11-21T19:49:49Z")
And there are those of us without health insurance, so we have no access to anything. (No money, no insurance-you get nothing.) ---
**Author:** ![Spoke](https://avatars.discourse-cdn.com/v4/letter/s/a88e57/32.png) [@Spoke](https://boards.straightdope.com/u/Spoke)\ **Post date:** [November 21, 2002, 7:52pm UTC](https://boards.straightdope.com/t/al-gore-s-health-care-plan-on-npr/137950/14 "2002-11-21T19:52:15Z")
> [@](#): > > This differs from Gore’s plan. He specifically said private insurance. I haven’t seen Gore’s plan, and he didn’t provide details in the snippet you posted. I’ll have to wait to critique it until I see it. > [@](#): > > For me “government efficiency” is all too often an oxymoron. So is “corporate efficiency.” Particularly when (as I pointed out above), a premium payer is paying not only to finance the insurance bureaucracy, but also some additional amount to make the insurance company profitable. > [@](#): > > Would there be legal or constitutional issues with the government taking over a normally private institution? You mean like air traffic control? > [@](#): > > If I understand correctly, the high cost that medical practitioners have to pay for insurance is a driving factor in the rising cost of health care. This is just some tricky blame-shifting by the insurance lobby. (By the way, do you mean to imply that doctors should not be held accountable for acts of negligence?) ---
**Author:** ![Tejota](https://avatars.discourse-cdn.com/v4/letter/t/958977/32.png) [@Tejota](https://boards.straightdope.com/u/Tejota)\ **Post date:** [November 21, 2002, 8:15pm UTC](https://boards.straightdope.com/t/al-gore-s-health-care-plan-on-npr/137950/15 "2002-11-21T20:15:59Z")
> [@](#): > > \*Originally posted by Threadkiller \* > \*\*This differs from Gore’s plan. He specifically said private insurance. No. he said private care. As in privately owned hospitals. Physicians working for themselves, etc. Single payer means the end of private health insurance, but not private health care providers. ---
**Author:** ![Threadkiller](https://avatars.discourse-cdn.com/v4/letter/t/aca169/32.png) [@Threadkiller](https://boards.straightdope.com/u/Threadkiller)\ **Post date:** [November 21, 2002, 8:51pm UTC](https://boards.straightdope.com/t/al-gore-s-health-care-plan-on-npr/137950/16 "2002-11-21T20:51:51Z")
> [@](#): > > \*Originally posted by spoke- \* > I haven’t seen Gore’s plan, and he didn’t provide details in the snippet you posted. I haven’t seen it either, the snippet I posted was about all he said about it–hence the OP. > [@](#): > > > [@](#): > > > > If I understand correctly, the high cost that medical practitioners have to pay for insurance is a driving factor in the rising cost of health care. > > This is just some tricky blame-shifting by the insurance lobby. Cite please. > [@](#): > > (By the way, do you mean to imply that doctors should not be held accountable for acts of negligence?) Not at all. Do you mean to imply that there are no frivolous malpractice lawsuits or unreasonable damage awards? ---
**Author:** ![Spoke](https://avatars.discourse-cdn.com/v4/letter/s/a88e57/32.png) [@Spoke](https://boards.straightdope.com/u/Spoke)\ **Post date:** [November 21, 2002, 9:00pm UTC](https://boards.straightdope.com/t/al-gore-s-health-care-plan-on-npr/137950/17 "2002-11-21T21:00:23Z")
> [@](#): > > Do you mean to imply that there are no frivolous malpractice lawsuits or unreasonable damage awards? Let’s just say I trust juries more than I trust the insurance lobby. Besides which, truly frivolous lawsuits are _dismissed_ (and the attorneys who file them are potentially liable for damages). Frivolous lawsuits (and there are some) often make big headlines when they are filed. But then when the judge dismisses such lawsuits, it seldom makes the papers. That selective coverage makes it seem like frivolous lawsuits are a bigger problem than they really are. ---
**Author:** ![erislover](https://avatars.discourse-cdn.com/v4/letter/e/71e660/32.png) [@erislover](https://boards.straightdope.com/u/erislover)\ **Post date:** [November 21, 2002, 9:04pm UTC](https://boards.straightdope.com/t/al-gore-s-health-care-plan-on-npr/137950/18 "2002-11-21T21:04:51Z")
> [@](#): > > And eris, I don’t think UDS was implying that some other countries healthcare system (as if they are all the same anyway) could be imposed without modification to the US… I’m quite sure he wasn’t. But he did imply that all it took was looking at what _they_ had to sacrifice to get universal health care going. I don’t have a problem with universal health care anymore, but I find no implementation that satisfies me whatsoever. If my opinion mattered to the rest of the population that might even count for something. 🙂 Universal health care still means that the best health care goes to the wealthy. Its just a matter of what everyone else gets, who pays for it, and who will do it for that pay. Simple. ---
**Author:** ![Spoke](https://avatars.discourse-cdn.com/v4/letter/s/a88e57/32.png) [@Spoke](https://boards.straightdope.com/u/Spoke)\ **Post date:** [November 21, 2002, 9:11pm UTC](https://boards.straightdope.com/t/al-gore-s-health-care-plan-on-npr/137950/19 "2002-11-21T21:11:13Z")
Oh yes, and as to the other point… Use some common sense, man. If the insurance lobby is able to convince the people (and their representatives) that the real reason for soaring health care costs is malpractice claims, then the insurance companies may have some chance of getting legislation passed which restricts patients in their ability to make claims against negligent doctors. Doctor sawed off the wrong foot? Too bad. Your damages will be limited to the cost of a prosthetic. I exaggerate for effect, of course, but that’s what so-called “tort reform” really is in this context – a constriction of patients’ rights. If the insurance lobby is successful in restricting patients’ rights to sue, then they can increase their profit margins accordingly. (Or do you really think those malpractice premiums will plummet if tort reform is passed? Do you really think there will be more than a token reduction in premiums?) Follow the money, my friend. ---
**Author:** ![Spoke](https://avatars.discourse-cdn.com/v4/letter/s/a88e57/32.png) [@Spoke](https://boards.straightdope.com/u/Spoke)\ **Post date:** [November 21, 2002, 9:18pm UTC](https://boards.straightdope.com/t/al-gore-s-health-care-plan-on-npr/137950/20 "2002-11-21T21:18:33Z")
Here’s a [letter to the editor](http://www.wsba.org/barnews/2002/02/letters.htm) of the Washington State Bar News (with citations) which nicely sums up my thoughts on the “malpractice crisis” myth. [Next page](https://boards.straightdope.com/t/al-gore-s-health-care-plan-on-npr/137950.md?page=2)